• 한국병원경영학회지
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• 제6권3호
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• pp.130-147
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• 2001

This study is about major symptoms of elderly and medical services for elderly in long-tenn care facilities. The subject of this study was 298 patients over 00 years old staying in two geriatric hospitals and two nursing homes. The symptoms and medical services were level of patient classification from RUG(Resource Utilization Group)-III which is applied for both Medicare and Medicaid for skilled nursing facilities reimbursement system in US and designed for measuring patient characteristics and medical staff time. This classification is explained by each patient resource(staff time) utilization level which is called CMI(Case-Mix Index). In this study, the symptoms and services were compared by facility type and they were categorized by level and compared by CMI. Major findings are as follows; 1. There were more elderly who have cognitive function problems in nursing homes than patients in geriatric hospitals. There were more patients with behavioral problems in geriatric hospitals than residents in nursing homes. These results were both statistically significant. 2. The patients in geriatric hospitals received significantly more nursing rehabilitation services, rehabilitation services and extensive services than residents in nursing homes. Other hands, special care services were provided significantly more to residents in nursing homes than elderly in geriatric hospitals. 3. ADL and depression variables had higher CMI when the symptoms were heavier condition. The CMI were not matched with levels of cognitive function problems and behavioral problems. 4. The CMI matched well significantly with levels of nursing rehabilitation services, special care services, and clinically complex services provided for the patient in geriatric hospitals and only nursing rehabilitation services in nursing homes. The CMI for rehabilitation services level and extensive services had regular trends. From the result of this study, the resource utilization level and services provided for elderly in each long-term care facilities were figured out. For the further study, it needs to have more concern about RUG-ill which classification variables were just analyzed.

• 지역사회간호학회지
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• 제33권4호
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• pp.357-371
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• 2022

Purpose: This study aims to investigate factors related to long-term length of stay (LOS) of patients with chronic diseases in Korean veterans hospitals. Methods: The subjects were 196 elderly patients with chronic disease staying in the hospital for more than 10 days, Data were collected by the survey of patients with structured questionnaires and medical records review by nurses from July 15 to August 10, 2019. Collected data were analyzed using t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression. Results: The present and desired LOS were 37.78±32.66 days and 60.87±45.95 days, respectively. Factors affecting hospital LOS were found to be main disease (genitourinary) (p<.001), assistance in activities of daily living (p<.001), area of hospital (p<.001), payment of medical fees (p=.026), hospital satisfaction (p=.036) and the explanatory power of these variables was 26.4%. The most common health problems that need to be solved after discharge were symptom alleviation and health promotion. These problems can be solved using community-based facility services or visiting medical-welfare services (especially home care nursing). Conclusion: In order to reduce hospital LOS, the following measures are required: personalized self-management education, provision of transportation services for dialysis therapy of inactive patients, linking patients with visiting medical-welfare services including home care nursing and mobile healthcare services, operation of the case management system including the notice of the discharge date at admission, interim check of patient status, and connecting the patient with community resources or transferring the patient to long-term care facilities at discharge.

• 한국식품영양학회지
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• 제22권1호
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• pp.141-149
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• 2009

본 연구의 분석결과, 컨조인트 도출모형의 적합성은 Pearson's R은 0.420, Kendall's tau는 0.402(<0.05)로 나타나 도출된 모형은 적합한 것으로 판정되었다. 급식서비스 속성에 대한 중요도는 영양사와의 상담이 51.2%로 가장 높았으며, 배식원의 서비스가 48.7%, 음식의 조리법이 0.1% 순으로 조사되었다. 급식서비스 각 속성의 효용성을 세부적으로 살펴보면 음식 의 경우 '부드러운 조리법 음식의 효용성'이 0.001로서 '일반적인 다양한 음식' -0.001보다 선호되고 있었다. 다음 배식원의 경우 '친절한 배식원의 서비스'가 0.086으로서 '신속한 배식원의 서비스' -0.086보다 선호되는 것을 보여주고 있다. 마지막으로 영양사 상담은 '주 1회'가 -0.138로서 '주2회' -0.2 6보다 선호되는 것을 나타내고 있다. 즉, '부드러운 조리법의 음식/친절한 배식원의 서비스/주 1회 영양사 상담'이 노인의료전문 병원의 환자들로부터 가장 선호되는 급식 서비스 프로파일로 나타나고 있다. 결론적으로 응답자들이 급식서비스를 선택할 때 가장 중요시 하는 속성은 영양사와의 상담(51.2%) 이었으며, 다음으로 배식원의 서비스(48.7%)이었다. 반면 음식의 조리법에 대한 중요도는 0.1%로서 음식의 조리법 자체는 급식서비스를 선택/선호하는 데에 거의 영향을 미치지 않으며, 그보다는 영양사의 상담과 배식원의 배달 서비스가 더욱 중요한 요인으로 파악되었다. 결과적으로 가상의 급식서비스 선호도 모델로써 제시된 8개의 모델에서 일반적인 조리방법, 친절한 말과 미소를 건네는 배식원의 서비스, 주 1회 담당 영양사와의 상담을 제시한 3번 모형이 가장 선호되는 것으로 조사되었다. 노인의료전문 병원 급식서비스의 중요 요소를 파악한 후 가상적인 급식소에 대한 상대적 중요도를 파악을 위한 컨조인트 분석을 실시하였다. 컨조인트 분석은 특정 제품이 가지고 있는 각각의 속성에 고객이 부여하는 효용을 추정함으로써, 고객이 선택할 제품을 예측하기 위한 기법으로 서로 다른 제품 속성에 대한 고객의 중요한 관점을 제시해 준다$^{26)}$. 즉 병원 급식에서 환자들은 정보를 얻고 가능한 대안들을 알고 난 후, 선택 속성의 패턴을 정의하여 이것을 급식소의 결정에 이용할 수 있게 된다. 노인의료전문 병원에서 급식서비스는 치료의 한 분야로써 그 중요성이 증가되고 있으며, 병원에 입원한 환자들을 위한 급식 서비스는 진료외적인 서비스의 한 요소로써 노인급식서비스의 향상을 위한 노력과 품질관리의 중요성이 부각되고 있다. 그러므로 본 연구에서 도출된 노인급식서비스 가상 모델은 노인의료전문 병원에서 행하여지는 급식서비스의 최적화 품질관리를 위하여 이용될 수 있을 뿐만 아니라 만족도 제고를 위하여 사용될 수 있을 것으로 사료된다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제27권3호
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• pp.61-69
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• 2021

Purpose: Senior long-term care facilities are vulnerable to a cluster infection because of frequent physical contact, large group dining, communal living, and room sharing. This study aims to provide architectural improvement plans for a quarantine system in the facilities. Methods: Actual quarantine action data, guidelines from governments and institutes, in-depth interviews with facility staff are analyzed. Results: To prevent a cluster infection in the senior facilities, it is necessary to provide an architectural plan focusing on increasing the number of single rooms and isolation rooms, providing isolation rooms for staff, separation of a soiled room from a clean room, planing an entry vestibule and a visitor's room. Implications: It is important to analyze the existing condition of facilities that had been going through cohort isolation and provide the architectural solution to strengthen infection control.

• 지역사회간호학회지
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• 제13권4호
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• pp.668-678
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• 2002

Purpose: The number of nursing home residents has been increasing in Korea. Nurses need to know the lived experience of relocation of the elderly to long-term care facilities. However, studies on this issue has not yet been conducted in Korea. Therefore, this study was carried out to understand the experience of institutionalization of the elderly using a phenomenological approach. Method: There were 11 participants who consisted of 5 men and 6 women living in 3 different nursing homes. The data was collected through in-depth interviews and participant observation from June 1999 to October 2001, and analyzed by Colaizzi's phenomenological method. Result: A total of 275 meaningful statements related to the experience of institutionalization by the elderly were obtained. Of the 275 statements, 175 were found as the statements with more general forms. 28 themes were grouped into 8 theme clusters. These theme clusters included' resentment at their sons', irresistible admission', 'humiliation on institutionalization', 'being unbearable to shock', 'grief to unfamiliarity', 'being in agony of outwards', 'regret for self-life' and 'comfort for new residence'. Conclusion: Based on these results. we can understand the lived experience of institutionalization of the Korean elderly. We need to develop a nursing program to help the elderly cope with this crisis, and studies about the familys experience on their parents admission to institutionalized facility warrant further exploration.

• 한국임상약학회지
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• 제32권4호
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• pp.321-327
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• 2022

Background: To implement medication management service in Korean nursing home (NH), medication review tool for residents in Korean long-term care facilities was developed. This prospective pilot study aimed to verify the applicability of this newly developed tool and to evaluate the drug related problems (DRPs) identified by pharmacists' medication review in NH setting. Methods: This study was carried out in two NHs in Korea. The elderly residents (65 or older) using 5 or more medications were eligible. Pharmacists conducted medication review and identified the DRPs and potentially inappropriate medications (PIMs) based on the newly developed tool. Results: Among 43 NH residents, 27 residents agreed to participate. The median age was 87 and about 55.6% of them were taking 10 or more medications. Pharmacists identified a total of 37 PIMs in 18 NH residents (66.7%) and 54 DRPs in 22 residents (81.5%). The most frequent PIM was general-PIM (26 cases) followed by PIM under specific diseases or conditions (7 cases). Out of 77 items contained in the tool, 15 items were detected in study participants. 'Continued use or regular daily use of hypnotics' was the most highly detected item (9 cases) followed by 'multiple prescriptions within each class of hypnotics/sedatives' (5 cases). Among 54 DRPs identified, pharmacist intervened 39 cases (72.2%) and interventions were accepted in 18 cases (46.1%). Conclusion: This pilot study demonstrated that newly developed tool is feasible for the nursing home residents. However, further studies with larger population are warranted.

• 사회복지연구
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• 제42권4호
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• pp.187-216
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• 2011

본 연구는 노인요양시설에 종사하는 사회복지사의 직무환경(역할갈등, 역할모호성, 역할 과다, 보상체계의 적절성)과 개인적 성향(정서적 공감성, 인지적 공감성, 외적 귀인성향, 내적 귀인성향)이 사회복지사의 소진(감정적 고갈, 개인적 성취감 저하, 클라이언트에 대한 비인격화)에 미치는 영향을 검증하여 노인요양시설에 종사하는 사회복지사의 소진을 예방할 수 있는 방안을 제시한 것이다. 노인장기요양기관으로 지정된 노인요양시설에 근무하는 사회복지사를 대상으로 설문조사를 실시, 수집된 총 312부의 자료를 기반으로 구조방정식모형을 통해 분석한 결과, 직무환경인 역할모호성은 개인적 성취감 저하와 클라이언트에 대한 비인격화에, 역할갈등과 역할과다는 감정적 고갈과 클라이언트에 대한 비인격화에 각기 유의미한 정(+)의 영향을 미치는 것을 알 수 있었으며, 개인적 성향인 인지적 공감성과 내적 귀인성향은 개인적 성취감 저하에 부(-)의 영향을, 외적 귀인성향은 감정적 고갈과 클라이언트에 대한 비인격화에 유의미한 정(+)의 영향을 미치는 것으로 알 수 있었다. 본 연구는 노인요양시설에 종사하는 사회복지사의 소진을 직무환경 뿐 아니라 개인적 성향에 주목해서 조명했다는 면에서 의의를 가진다.

• 한국화재소방학회논문지
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• 제32권4호
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• pp.50-59
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• 2018

고령화 추세에 따라 최근 급속히 증가하고 있는 노인복지시설에서 화재가 빈번하게 발생하고 있으나, 거주하고 있는 와상노인에 대한 피난안전성이 확보되어 있지 않아 대규모 인명피해를 초래하고 있다. 이런 시설에 거주하는 와상노인에 대한 피난안전성의 실효성을 제고하기 위한 방법의 일환으로 비화재구역의 피난허용시간을 최대한 연장시키면서 발코니 등의 일시피난안전구역에 차례로 피난시키고, 소방기관에 통보하는 화재속보설비를 통해 소방대의 출동에 의한 외부 조력피난유도방법이 최선의 대책인 것으로 판명되었다. 따라서 이와 같은 조력피난을 수행하는데 있어 반드시 적용해야할 요소기술을 방화 소방공학적으로 개발하여 4가지로 분류 제시하였다. 방화공학적 요소기술로는 구조 구획의 내화성능확보와 구획의 소규모화 규제 조항과 마감재의 난연 불연성능의 확보 규제 조항인 2가지를 제시하였다. 또한 소방공학적 요소기술로는 스프링클러에 의한 냉각효과 부과 규제 조항과 소방기관으로의 자동화재속보기능의 부여 규제 조항인 2가지를 제시하였다. 제시된 규제 조항에 대하여 일본과 국내의 법조문을 상세히 비교분석하여 국내에서 개정한 법조문상 미흡한 부분을 고찰하고, 국내의 노인복지시설의 피난안전성의 제고를 위해 시급하게 개선되어야 할 안전기준 개정(안)을 제시하였다.

• 지역사회간호학회지
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• 제32권3호
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• pp.233-242
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• 2021

Purpose: The purpose of this study was to verify influencing factors affecting service quality provided by caregivers working for the elderly with dementia. Methods: Data were collected using a self-reported questionnaire from 214 caregivers in a long-term care facility in D city. The data were analyzed with service quality, dementia knowledge, work value, and job performance confidence. For data analysis, the descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression were performed using SPSS/WIN 21.0 program. Results: There were significant differences in service quality depending on the health status. Factors influencing service quality were work value, and job performance confidence with R² value of 38%. The highly influencing factors were work value, and job performance confidence. Conclusion: The results of this study indicate that the effort to improve the service quality of caregivers should focus on work value and job performance confidence.

• 대한간호학회지
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• 제39권2호
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• pp.166-176
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• 2009

Purpose: The purpose of the study was to identify functional structure and patterns of dialogue sequence in conversations between elderly patients with dementia and nurses in a long-term care facility. Methods: Conversation analysis was used to analyze the data which were collected using video-camera to capture non-verbal as well as verbal behaviors. Data collection was done during February 2005. Results: Introduction, assessment, intervention, and closing phases were identified as functional structure. Essential parts of the conversation were the assessment and intervention phases. In the assessment phase three sequential patterns of nurse-initiated dialogue and four sequential patterns of patient-initiated dialogue were identified. Also four sequential patterns were identified in nurse-initiated and three in patient-initiated dialogues in the intervention phase. In general, "ask question", "advise", and "directive" were the most frequently used utterance by nurses in nurse-initiated dialogue, indicating nurses' domination of the conversation. At the same time, "ask back", "refute", "escape", or "false promise" were used often by nurses to discourage patients from talking when patients were raising questions or demanding. Conclusion: It is important for nurses to encourage patient-initiated dialogue to counterbalance nurse-dominated conversation which results from imbalance between nurses and patients in terms of knowledge and task in healthcare institutions for elders.